Clinical Scenario

You attend a continuing professional development course on all things farm animal production. During the coffee break, a discussion arises about castration of calves and the use of anti-inflammatories. There is one vet who is quite vocal about using both ketoprofen and local anaesthetic. You tend to use just local anaesthetic for your castrations, and you wonder whether the calves would perform better post-surgery if you used ketoprofen as well.

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

[calf.mp. OR calves.mp. OR bovine.mp. OR bovines.mp. OR young stock.mp. OR youngstock.mp. OR cattle.mp. OR exp Cattle/]

AND

[castrat$.mp. OR sterilis$.mp. OR steriliz$.mp. OR neuter$.mp. OR desex$.mp. OR de sex$.mp. OR orchiect$.mp. OR orchidect$.mp. OR gonadect$.mp. OR exp Castration/ OR exp Orchiectomy/]

AND

[local anaesthe$.mp. OR local anesthe$.mp. OR regional anaesthe$.mp. OR regional anesthe$.mp. OR nerve block.mp. OR exp Anesthetics, local/ OR exp Anesthesia, local/ OR exp Nerve block/ OR ketoprofen.mp. OR ketofen.mp. OR ketophen.mp. OR exp Ketoprofen/]

CAB Abstracts 1910 to Present using the OVID interface

[calf.mp. OR calves.mp. OR bovine.mp. OR bovines.mp. OR young stock.mp. OR youngstock.mp. OR cattle.mp. OR exp calves/ OR exp cattle/]

AND

[castrat$.mp. OR sterilis$.mp. OR steriliz$.mp. OR neuter$.mp. OR desex$.mp. OR de sex$.mp. OR orchiect$.mp. OR orchidect$.mp. OR gonadect$.mp. OR exp gonadectomy/ OR exp castration/]

AND

[local anaesthe$.mp. OR local anesthe$.mp. OR regional anaesthe$.mp. OR regional anesthes$.mp. OR nerve block.mp. OR exp local anaesthetics/ OR exp local anaesthesia/ OR ketoprofen.mp. OR ketofen.mp. OR ketophen.mp. OR exp ketoprofen/]

Key Results:

The way the results are displayed in Table 3 of the paper makes it difficult to interpret whether the results are significantly different from each other in relation to the specific groups. Our assumption is that there is no significant difference between the group given ketoprofen plus local anaesthetic and the group given local anaesthetic in relation to ADFI.

There appears to be no significant difference between the group given ketoprofen plus local anaesthetic, and the group given local anaesthetic in relation to ADG.

Study Weaknesses:

The paper states that calves were randomly assigned to the different treatment groups, but does not report how randomisation was carried out

There was no information given as to who administered the interventions, or whether they were blinded

There was no information given as to whether the outcomes were assessed blind (or by whom)

There was no justification of sample size

No statistical significance level was stated in the methods

Results were reported in an aggregated format, therefore it is difficult to assess whether all subjects completed the study

The way that the results are set out in Table 3 makes it difficult to assess whether there are significant differences in ADFI between calf groups given local anaesthetic alone, and those given local anaesthetic and ketoprofen

The authors state that there were no significant differences in ADFI and ADG between the local anaesthetic, and local anaesthetic and ketoprofen groups, but conclude that the addition of ketoprofen may facilitate improved performance

Attachment:

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Comments

The outcome of interest in this BET was not the primary outcome of interest in the Earley and Crowe paper.

Administration of ketoprofen via intravenous injection only (and not via intramuscular injection), was assessed in this study.

This BET does not address the use of ketoprofen for pain relief; this is another important consideration for veterinarians performing this procedure.

An additional paper by Stafford et al. (2002) in Research in Veterinary Science73: 61-70 stated that comparisons were made between calves undergoing surgical castration with local anaesthetic, and local anaesthetic plus ketoprofen, but it is difficult to determine the results of these comparisons (it is possible that comparisons between castration methods only has occurred) so this was not included in this BET. This paper could, however, be a useful resource comparing other types of castration and the addition of local anaesthetic and NSAIDs.

Bottom line

The evidence surrounding the use of ketoprofen plus local anaesthetic versus local anaesthetic alone in relation to surgical castration of calves and future performance is inconclusive and further quality trials are required.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It
is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on
the specific circumstances of patients under their care, taking into account other factors such as local
licensing regulations. Read small print

References

Earley B, Crowe MA (2002). Effects of ketoprofen alone or in combination with local anesthesia during the castration of bull calves on plasma cortisol, immunological, and inflammatory responses. Journal of Animal Science80: 1044-1052.